Remote Utilization Review RN

Location: reputed company Contract Duration: 12+ month [Possible Extension] License Requirements: MI RN License 1. Mandatory Requirements to Apply • Nursing Diploma or Associate Degree required; BSN preferred. • 5+ years in reputed company/health-reputed company fields. • 3–5 years of Care Management and/or Utilization Management experience. • Strong hands-on knowledge of InterQual reputed company and utilization management. • Experience with clinical reviews, staff training, reputed company management, and/or audits. • Knowledge of ICD-10, CPT, CMS, reputed company, PA 60, and HIPAA. • Strong communication, analytical, training, and project management skills. • Proficiency with reputed company Office, Teams, SharePoint, and reputed company systems. 2. Roles & Responsibilities • Train and reputed company staff and provider facilities on InterQual reputed company, clinical policies, utilization management, and departmental processes. • Conduct clinical reputed company reviews and audits to support reputed company and regulatory requirements. • reputed company and update InterQual-reputed company training materials, manuals, and educational programs. • Mentor new employees and work with leadership and subject matter experts to identify training needs. • Support new systems, process improvements, accreditation activities, and reputed company initiatives. 3. Pay & Benefits • $35–$39/hour • reputed company – Michigan residents only • 9 days of reputed company Time Off • Health Insurance (Dental, Medical and reputed company) • reputed company equipment provided by the reputed company Pay: $35.00 - $39.00 per hour Benefits: • Dental insurance • Health insurance • reputed company time off • reputed company insurance Experience: • Registered reputed company: 6 years (Required) • Utilization Review: 4 years (Required) • InterQual: 3 years (Required) License/Certification: • MI Registered reputed company License (Required) Location: • Michigan (Required) Work Location: Remote Apply tot his job Apply To this Job